Active NPI
Edwin Teehan, MD
- Surgery Physician
- Wayne, NJ
National Provider Identifier
1366491532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MA056236
- Practice address
- 510 Hamburg Tpke
Suite 205
Wayne, NJ 07470-2025 - Phone
- (973) 720-8333
- Fax
- (973) 720-0408
- NPI assigned
- May 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MA056236 | NJ | Primary |
Addresses
Primary practice location
510 Hamburg Tpke
Suite 205
Wayne, NJ 07470-2025
Mailing address
PO Box 4015
Clifton, NJ 07012-0415
Phone (973) 720-8333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6947204 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040512000958 | NJ | Practitioner - General Surgery | 3173513272 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
510 Hamburg Tpke
Suite 205
Wayne, NJ 07470-2033
Phone (973) 720-8333
Hospital & facility affiliations
- Valley Home Care Inc.
- St Mary'S General Hospital
- Chilton Medical Center
- St Joseph'S University Medical Center Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 19 |
| Hernia repair (minimally invasive) | 1-10 |
| Varicose vein removal | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 178 |
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA056236 | NJ | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edwin P Teehan MD PC | Current | Accepting new patients |
Locations
1135 Clifton Ave
Ste 206
Clifton, NJ 07013
Phone (201) 261-1772
1900 Union Valley Rd
Ste 303
Hewitt, NJ 07421
Phone (973) 473-5700
510 Hamburg Tpke
Ste 205
Wayne, NJ 07470
Phone (973) 720-8333
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Passaic, NJ
- NPI 1770901761
Hospital
-
- General Acute Care Hospital
- Paterson, NJ
- NPI 1669462420
Hospital
-
- Home Health Agency
- Paramus, NJ
- NPI 1174588925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318982400000",
"number": "1366491532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4015",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070120415",
"telephone_number": "973-720-8333",
"fax_number": "973-720-0408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 HAMBURG TPKE",
"address_2": "SUITE 205",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074702025",
"telephone_number": "973-720-8333",
"fax_number": "973-720-0408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEEHAN",
"first_name": "EDWIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-08",
"last_updated": "2011-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NJ",
"license": "MA056236",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6947204",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wayne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.